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Five cases of aconite poisoning: toxicokinetics of aconitines

Yuji Fujita1, Katsutoshi Terui, Megumi Fujita

  • 1Poisoning and Drug Laboratory Division, Critical Care and Emergency Center, Iwate Medical University Hospital, 3-16-1 Honchoudori, Morioka, Iwate 020-0015, Japan.

Journal of Analytical Toxicology
|June 21, 2007
PubMed

Insights

Aconite poisoning can cause severe cardiac arrhythmias. Toxicokinetic parameters, like alkaloid half-life, may indicate poisoning severity, with longer half-lives correlating to worse outcomes.

Area of Science:

  • Toxicology
  • Cardiology
  • Pharmacokinetics

Background:

  • Aconite poisoning is a serious medical condition.
  • Cardiac arrhythmias are a common manifestation of aconite toxicity.

Purpose of the Study:

  • To investigate the relationship between toxicokinetic parameters of aconite alkaloids and the severity of poisoning.
  • To analyze electrocardiogram (ECG) findings in patients with aconite poisoning.

Main Methods:

  • Case series analysis of five patients with aconite poisoning.
  • Electrocardiogram (ECG) monitoring.
  • Pharmacokinetic analysis of aconite alkaloids, including half-life, area under the curve (AUC), and mean residence time (MRT).

Main Results:

  • Patients presented with various ventricular arrhythmias, including ventricular tachycardia and fibrillation.
  • Alkaloid half-lives ranged from 5.8 to 15.4 hours.
  • Case 1, with the longest alkaloid half-life (twice that of others), showed significantly higher AUC and MRT, alongside unstable hemodynamics requiring percutaneous cardiopulmonary support.

Conclusions:

  • Toxicokinetic parameters, particularly the half-life of aconite alkaloids, appear to correlate with the severity of clinical manifestations in aconite poisoning.
  • These parameters may serve as valuable indicators for assessing and managing aconite poisoning cases.

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